OSAHS合并RLS的急性脑梗死临床特点分析  

Clinical Characteristics of Acute Cerebral Infarction in Patients With OSAHS and RLS

作　　者：王瑾[1] 罗国刚[1] 李雪蓉 林舒琪 WANG Jin;LUO Guogang;LI Xuerong;LIN Shuqi(Department of Neurology,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an Shaanxi 710061,China;Department of Neurology,Fujian Medical University Affiliated Xiamen Hong′ai Hospital,Xiamen Fujian 361016,China)

机构地区：[1]西安交通大学第一附属医院神经内科,陕西西安710061 [2]福建医科大学附属厦门弘爱医院神经内科,福建厦门361016

出　　处：《中国卫生标准管理》2023年第17期92-96,共5页China Health Standard Management

摘　　要：目的 分析存在阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)与右向左分流(right-to-left shunt,RLS)的急性脑梗死的临床特点。方法 收集2020年7月—2022年11月就诊于福建医科大学附属厦门弘爱医院神经内科的急性脑梗死患者,已完善多导睡眠监测(polysomnography monitoring,PSG)及经颅多普勒超声发泡试验(contrast transcranial Doppler,cTCD)检查。将其分为观察组(OSAHS及RLS均阳性)、对照组(OSAHS及RLS均阴性)。对照两组患者的基本信息、一般临床资料、血液学检验[包括总胆固醇(total cholesterol,TCHO)、三酰甘油(triglyceridetriacyl glyceroltag,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、尿酸、D-二聚体]、是否为醒后卒中、Org10172试验(trial of org 10172 in acute stroke treatment,TOAST)分型病灶分布(前循环/后循环/前后循环)、责任动脉(大动脉/小动脉)等,比较上述指标在观察组与对照组之间的差异。结果 入组患者43例,其中观察组23例,对照组20例,观察组年龄、高血压患病率、TG均明显高于对照组;后循环病灶占比、醒后卒中比例观察组均明显高于对照组(P <0.05)。两组性别、吸烟饮酒史、糖尿病病史、冠心病病史、尿酸、D-二聚体、TOAST分型、颅外责任动脉、颅内累及动脉的大小、病灶同时累及前后循环、洼田饮水试验分级、格拉斯哥昏迷量表评分(Glasgow coma scale,GCS)、出入院美国国立卫生研究院中风量表(National Institute of Health stroke scale,NIHSS)等比较,差异均无统计学意义(P> 0.05)。结论 合并OSAHS与RLS的急性脑梗死患者中高血压更多,更易发生醒后卒中,后循环病灶更为多见。Objective To analyze the clinical features of acute cerebral infarction with obstructive sleep apnea hypopnea syndrome(OSAHS) and right-to-left shunt(RLS).Methods From June 2020 to October 2022,patients with acute cerebral infarction in department of neurology,Fujian Medical University Affiliated Xiamen Hong′ai Hospital were collected,and polysomnography and transcranial doppler ultrasound foaming test were improved.They were divided into observation group(OSAHS and RLS were positive) and control group(OSAHS and RLS were negative).Basic information,general clinical data,hematological tests [including total cholesterol(TCHO),triglycerideglyceroltag(TG),low density lipoprotein cholesterol(LDL-C),uric acid,D-dimer],waking stroke or not,(trial of org 10172 in acute stroke treatment(TOAST) classification,focal distribution(anterior circulation/posterior circulation/anterior-posterior circulation),responsibility artery(large artery/small artery) and so on were compared between the two groups.The differences of the above indexes between the observation group and the control group were compared.Results A total of 43 patients were enrolled,including 23 cases in the observation group and 20 cases in the control group.The age,prevalence of hypertension and TG in the observation group were significantly higher than those in the control group.The proportion of posterior circulation lesions and the proportion of stroke after awakening in the observation group were significantly higher than those in the control group(P<0.05).There were no significant differences in gender,smoking and drinking history,history of diabetes,history of coronary heart disease,uric acid,D-dimer,toast classification,extracranial responsible artery,size of intracranial involved artery,lesions involving both anterior and posterior circulation,classification of drinking water test,Glasgow coma scale(GCS) score,and National Institute of Health stroke scale(NIHSS) score between the two groups(P>0.05).Conclusion Acute cerebral infarction patients with OSAH

关 键 词：急性脑梗死 阻塞性睡眠呼吸暂停低通气综合征 右向左分流 醒后卒中 高血压 脂代谢异常 

分 类 号：R743[医药卫生—神经病学与精神病学]